Once my parent is down to $2,000 and Medicaid elegible, how long does it take? I am hearing that I should appy when there's 3 months worth of money because it takes that long for Medicaid to get to the application/approval...
Also, what if my parent is receiving $2,071.00 each month from Soc Sec? Does that mean she will NEVER be elegible?
You will apply when parent meets the asset threshold that the state your parent resides has set. The income of $2,071.00 is a not direct factored for determining elegibility but it is essential to have her asset limit met before applying.
The income does play a factor in what you will contribute on a monthly basis to offset the total cost of the monthly amount Mediciad has set to pay facilities. For example, For long term care the Mediciad amount the state will pay is $7,000 per month. Your mothers income is $2,071 with a $50 personal allowance deduction. Therefore, your mother pays the facility $2,021, a separate payment of $50 for her personal allowance, and the state will pay $4,979 to cover differance of the set amount of $7,000.
When your application is sent, her elegibily goes into the pending phase. During this phase she will be responsible to only pay what her monthly income is less the state determined personal allowance and this is paid directly to the long term care facility. No other self pay payments are necessary. It does take 3-6 months to approve and you may need to send additional support after the initial application.
Once accepted the POA/guardian, facility and attorney (if used) will receive a letter that states the monthly "NAMI" amount is to be paid to the facility. On the approval letter there will be an effective date that is typically the date of application unless major penalties are found.
For my dad, the nursing home helped me submit an application with some documents the middle of August. We knew he wouldn't get Medicaid for August because he had too much in his checking account on August 1st. In our state anyway, he had to have under $2000 on the 1st day of each month to qualify.
Medicaid set up a phone interview to ask questions and tell me what other documents they needed for August 26th. Thankfully the nursing home told me when that was because I never got anything from Medicaid about the interview. They said I had to turn in the documents by Sept 8th to qualify for Sept (he did have less than $2000 in the bank on Sept 1st).
I was informed on Sept 17th that he was approved for Sept.
In our state, his income (social security and a small pension) had to be less than $2900 (approx, don't remember the exact amount) a month.
He has to pay all of his income minus $52 per month to the nursing home.
Folks often get fixated on the $ aspect but the “medically at need for skilled nursing care” aspect is just as important. The State will review the applicants health care records. And it has to clearly show skilled nursing required. A note from their doctor in & of itself won’t be enough.
The majority of NH placements are this scenario: a mom living on her own falls and breaks a hip; mom is hospitalized & gets hip replacement surgery; mom is discharged for post surgery rehabilitation in a NH/SNF with a rehab unit (all this so far is covered in some way by health insurance); mom eventually stops progressing in rehab and a determination is made that she cannot go back to her former living situation so mom will stay in the NH/SNF; mom stays at the SNF and segueways from being a rehab patient (on insurance) to a long term custodial care resident (private pay, LTC insurance or LTC Medicaid). This mom has a recent nice & thick health chart that clearly & minute detail show her to be “at need for skilled nursing care”.
But for those who enter a NH directly, that recent & extensive hospital/rehab details wont exist. Medicaid will do a review of the health chart the SNF/NH submits to them and Medicaid can send out their own assessment team to review the applicant in person. If this is how your family member is entering the NH, clearly speak with admissions as to how intense your State is on the health chart review.